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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> (10AV2009-02:11:24 P <br /> Page of <br /> I. FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> PEP BOYS #711 <br /> CHEMICAL LOCATION 201 rCAL LOCATION CONFIDENTIAL EPCRA 202 <br /> SERVICE AREA <br /> ❑X YES❑NO <br /> FACILITY IDA1 MAP#ired by SJ 1/F7GRIDqO�==203/204 <br /> Requ <br /> II. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(l 1) O YES ®NO 206 <br /> USED OIL PETROLEUM N.O.S. If Subject to MCRA,refer to instructions <br /> COMMON NAME 207 EFis OYES ®NO 208 <br /> USED MOTOR OILS <br /> CAS# 209 <br /> MIXTURE *If EHS is "Yes",all amounts must be in lbs. <br /> FIRE CODE HAZARD CLASSES(Complete if required by CUPA) 210 <br /> LEAVE BLANK <br /> HAZ RDOU(Check AS oMATERIAL <br /> item TERI Lly) D a.PURE 13 b.MIXTURE ®e.WASTE 211 RADIOACTIVE®YES N NO 212 CURIES N/A 213 <br /> TYPPHYSICAL STATE O SOLID.10 LIQUID O GAS 214 LARGEST CONTAINER 215 <br /> (Check one item only) 250 <br /> FED HAZARD CATEGORIES ®FIRE O REACTIVE O PRESSURE RELEASE O ACUTE HEALTH O CHRONIC HEALTH 216 <br /> (Check all that apply) <br /> AVERAGE DAILY AMOUNT::JMAXIMUMDAILY AMOUNT 21 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 180 250 3500 221 <br /> UNITS* O GAL ❑CULT O LBS O TONS 221 1 DAYS ON SITE 222 <br /> (Check on item only *If EHS,amount must be in pounds. 365 <br /> STORAGE ®ABOVE GROUND TANK O CARBOY O GLASS BOTTLE O Other... <br /> CONTAINER O UNDER GROUND TANK O SILO O PLASTIC BOTTLE <br /> O TANK INSIDE BUILDING O FIBER DRUM O TOTE BIN <br /> O STEEL DRUM O BAG O TANK WAGON <br /> O PLASTIC/NONMETALLIC DRUM O BOX O RAIL CAR <br /> O CAN O CYLINDER O OTHER <br /> 223 <br /> STORAGE PRESSURE ®AMBIENT OABOVE AMBIENT O BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE O AMBIENT O ABOVE AMBIENT O BELOW AMBIENT O CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT or mixture or waste on! EHS CAS# <br /> 83-93 226 aliphatic petroleum distillates 227 O YES ®NO 22$ 64742-65-0 229 <br /> 6-16 230 detergent/dispersant oil package 231 O YES ONO 232 233 <br /> 1.0 234 zinc compounds 235 O YES ®NO 236 68649-42-3 237 <br /> 238 239 ❑YES ONO 240 241 <br /> 242 243 ❑YES ❑NO 244 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1270 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? Lubricant removed during service operations&returns from public. <br /> UPCF(Rev.12/2007) If EPCRA,Please Sign Here <br />